and addresses several common arguments against adopting presumed consent. Part III examines the possible impact of presumed consent on eye and
tissue donation, including procurement rates and other aspects of the field.
Part IV analyzes the positive effects presumed consent may have on donor
families and resulting secondary effects on views of donation.

II. PUBLIC HEALTH AND PRESUMED CONSENTThe current U.S. approach to donation is an opt-in system that relies onindividuals registering as donors.
10 Under this regime, for individualswhose wishes are unknown at death, decision-making falls to next of kin.
11Because actual consent is required, the default is non-consent.
12 Presumedconsent reverses the process, requiring those individuals opposed to dona-tion to register their objection, thus transforming the process by making do-nation the default rule rather than the exception. Presumed consent facessignificant opposition on the basis of core bioethical principles.
13 Ultimate-ly, however, presumed consent is less dramatically different from the exist-ing system than initial appearances might suggest, and it may yield signifi-cant public health benefits.

The Uniform Anatomical Gift Act (UAGA), revised most recently in
2009 and adopted by the vast majority of states,
14 grants authority for persons to donate bodily tissue after death.
15 The UAGA and state implementing legislation16 strongly emphasize donor autonomy. Persons may register
consent to donate directly via a donor registry or may state their wishes in

10. The Uniform Anatomical Gift Act, which articulates an opt-in regime, has been
adapted in forty-six states and the District of Columbia, and has been proposed in Pennsylvania in 2014. Nat’l Conference of Comm’rs on Unif. State Laws, Anatomical Gift Act
(2006), http://www.uniformlaws.org/Act.aspx?title=Anatomical%20Gift%20Act%20(2006).